治妇女阴挺，亦治肝气虚弱，郁结不舒。
生黄 （六钱） 当归（三钱） 知母（三钱） 柴胡（一钱五分） 生明乳香（三钱） 生明没药
（三钱） 川芎（一钱五分）
肝主筋，肝脉络阴器，肝又为肾行气。阴挺自阴中挺出，形状类筋之所结。病之原因，为肝气郁而下陷
无疑也。故方中黄 与柴胡、芎 并用，补肝即以舒肝，而肝气之陷者可升。当归与乳香、没药并用，养肝即
以调肝，而肝气之郁者可化。又恐黄 性热，与肝中所寄之相火不宜，故又加知母之凉润者，以解其热也。
一妇人，年三十余。患此证，用陈氏《女科要旨》，治阴挺方，治之不效。因忆《傅青主女科》有治阴
挺之方，其证得之产后。因平时过怒伤肝，产时又努力太过，自产门下坠一片，似筋非筋，似肉非肉，用升补
肝气之药，其证可愈。遂师其意，为制此汤服之。数剂即见消，十剂全愈。
一室女，年十五。因胸中大气下陷，二便常觉下坠，而小便尤甚。乃误认为小便不通，努力强便，阴中
忽坠下一物，其形如桃，微露其尖，牵引腰际下坠作疼，夜间尤甚，剧时号呼不止。投以理郁升陷汤，将升麻
加倍，二剂疼止，十剂后，其物全消。盖理郁升陷汤，原与升肝舒郁汤相似也。
治室女月闭血枯，饮食减少，灼热咳嗽。
白术（三钱，炒） 生怀山药（一两） 生鸡内金（二钱，黄色的） 龙眼肉（六钱） 山萸肉（四钱，去净核）
枸杞果（四钱） 玄参（三钱） 生杭芍（三钱） 桃仁（二钱） 红花（钱半） 甘草（二钱）
灼热不退者，加生地黄六钱或至一两。咳嗽者，加川贝母三钱，米壳二钱（嗽止去之）。泄泻者，去玄参，
加熟地黄一两，云苓片二钱，或更酌将白术加重。服后泻仍不止者，可于服药之外，用生怀山药细末煮粥，搀
入捻碎熟鸡子黄数枚，用作点心，日服两次，泻止后停服。大便干燥者，加当归、阿胶各数钱。小便不利者，
加生车前子三钱（装袋），地肤子二钱或将芍药（善治阴虚小便不利）加重。肝气郁者，加生麦芽三钱，川芎、
莪术各一钱。汗多者，将萸肉改用六钱，再加生龙骨、生牡蛎各六钱。
《内经》谓“二阳之病发心脾，有不得隐曲，在女子为不月。”夫二阳者，阳明胃腑也。胃腑有病，不
能消化饮食，推其病之所发，在于心脾。又推其心脾病之所发，在于有不得隐曲（凡不能自如者皆为不得隐曲）。
盖心主神脾主思，人有不得隐曲，其神思郁结，胃腑必减少酸汁（化食赖酸汁，欢喜则酸汁生者多，忧思则酸
汁生者少），不能消化饮食，以生血液，所以在女子为不月也。夫女子不月，既由于胃腑有病，不能消化饮食。
治之者，自当调其脾胃，使之多进饮食，以为生血之根本。故方中用白术以健胃之阳，使之 动有力（饮食之
消亦仗胃有 动）。山药、龙眼肉，以滋胃之阴，俾其酸汁多生。鸡内金原含有酸汁，且能运化诸补药之力，
使之补而不滞。血虚者必多灼热，故用玄参、芍药以退热。又血虚者，其肝肾必虚，故用萸肉、枸杞以补其肝
肾。甘草为补脾胃之正药，与方中萸肉并用，更有酸甘
化阴之妙。桃仁、红花为破血之要品，方中少用之，非取其破血，欲借之以活血脉通经络也。至方后附载，因
证加减诸药，不过粗陈梗概，至于证之更改多端，尤贵临证者，因时制宜耳。
沧州曹姓女，年十六岁，天癸犹未至。饮食减少，身体羸瘦，渐觉灼热。其脉五至，细而无力。治以资
生通脉汤，服至五剂，灼热已退，饮食加多。遂将方中玄参、芍药各减一钱，又加当归、怀牛膝各三钱。服至
十剂，身体较前胖壮，脉象亦大有起色。又于方中加樗鸡（俗名红娘虫）十枚，服至七八剂，天癸遂至。遂减
去樗鸡，再服数剂，以善其后。
奉天马氏女，自十四岁，月事已通，至十五岁秋际，因食瓜果过多，泄泻月余方愈，从此月事遂闭。延
医延医，至十六岁季夏，病浸增剧，因求为延医。其身形瘦弱异常，气息微喘，干嗽无痰，过午潮热，夜间尤
甚，饮食减少，大便泄泻。其脉数近六至，微细无力。俾先用生怀山药细末八钱，水调煮作粥，又将熟鸡子黄
四枚，捻碎搀粥中，再煮一两沸，空心时服。服后须臾，又服西药百布圣二瓦，以助其消化。每日如此两次，
用作点心，服至四日，其泻已止。又服数日，诸病亦稍见轻。遂投以资生通脉汤，去玄参加生地黄五钱、川贝
三钱，连服十余剂，灼热减十分之八，饮食加多，喘嗽亦渐愈。遂将生地黄换作熟地黄，又加怀牛膝五钱，服
至十剂，自觉身体爽健，诸病皆无，惟月事犹未见。又于方中加 虫（即土鳖虫，背多横纹者真，背光滑者非
是）五枚、樗鸡十枚，服至四剂，月事已通。遂去 虫、樗鸡，俾再服数剂，以善其后。
马姓女十七岁。自十六岁秋际，因患右目生内障，服药不愈，忧思过度，以致月闭。自腊月服药，直至
次年孟秋月底不愈，求为延医。其人体质瘦弱，五心烦热，过午两颧色红，灼热益甚，心中满闷，饮食少许，
即停滞不下，夜不能寐。脉搏五
至，弦细无力。为其饮食停滞，夜不能寐，投以资生通脉汤，加生赭石（研细）四钱，熟枣仁三钱，服至四剂，
饮食加多，夜已能寐，灼热稍退，遂去枣仁，减赭石一钱，又加地黄五钱，丹皮三钱，服约十剂，灼热大减。
又去丹皮，将龙眼肉改用八钱，再加怀牛膝五钱。连服十余剂，身体浸壮健。因其月事犹未通下，又加 虫五
枚、樗鸡十枚。服至五剂，月事已通。然下者不多，遂去樗鸡、地黄，加当归五钱，俾服数剂，以善其后。
治疗妇女子宫脱垂（阴挺），同时也适用于肝气虚弱、郁结不畅的病证。
生黄芪（六钱） 当归（三钱） 知母（三钱） 柴胡（一钱五分） 生明乳香（三钱） 生明没药（三钱） 川芎（一钱五分）
肝脏主管筋脉，肝经的脉络连接外阴器官，肝脏又负责为肾脏运行气机。子宫脱垂从阴道中突出，形状类似筋脉的结节。发病的原因，无疑是肝气郁结且向下陷落。因此，方剂中黄芪与柴胡、川芎并用，补益肝脏即是疏泄肝脏，从而使下陷的肝气得以升提。当归与乳香、没药并用，滋养肝脏即是调理肝脏，从而使郁结的肝气得以化解。又担心黄芪性味温热，不适合肝脏中所寄居的相火（生理之火），所以加入知母的凉润之性，以解除其热性。
有一位三十多岁的妇人，患有此病，曾用陈氏《女科要旨》中治疗子宫脱垂的方子，治疗无效。于是想起《傅青主女科》中有治疗产后子宫脱垂的方子，该病症是因为平时过度愤怒损伤肝脏，生产时又用力过猛，导致自产门坠出一块东西，似筋非筋，似肉非肉，使用升提补益肝气的药物，病症可以痊愈。于是效法其意，配制了这汤剂让她服用。服用几剂后症状即见消退，服用十剂后完全痊愈。
有一位十五岁的未婚女子，因为胸中大气下陷，大小便常感觉有下坠感，而小便尤为严重。被误认为是小便不通，努力强行排尿，结果阴道中突然坠下一物，形状像桃子，微微露出尖端，牵引腰部下坠作痛，夜间尤其严重，剧痛时大声呼号不止。投用理郁升陷汤，将升麻加倍用量，两剂后疼痛停止，十剂后，下垂之物完全消失。大概理郁升陷汤，原本与升肝舒郁汤相似。
白术（三钱，炒制） 生怀山药（一两） 生鸡内金（二钱，黄色的） 龙眼肉（六钱） 山茱萸肉（四钱，去净核） 枸杞果（四钱） 玄参（三钱） 生杭芍（三钱） 桃仁（二钱） 红花（钱半） 甘草（二钱）
若发热不退，加生地黄六钱或至一两。若有咳嗽，加川贝母三钱，罂粟壳二钱（咳嗽停止后去掉）。若有泄泻，去掉玄参，加熟地黄一两，云苓片二钱，或者酌情加重白术的用量。服药后腹泻仍不止者，可在服药之外，用生怀山药细末煮粥，掺入捻碎的熟鸡蛋黄数枚，作为点心，每日服用两次，腹泻停止后停服。大便干燥者，加当归、阿胶各数钱。小便不利者，加生车前子三钱（装袋煎煮），地肤子二钱或将芍药（善于治疗阴虚所致的小便不利）加重用量。肝气郁结者，加生麦芽三钱，川芎、莪术各一钱。汗多者，将山茱萸改用六钱，再加生龙骨、生牡蛎各六钱。
《内经》说：“二阳之病发心脾，有不得隐曲，在女子为不月。”所谓二阳，是指阳明胃腑。胃腑有病，不能消化饮食，推究疾病的发生源头，在于心脾。再推究心脾疾病的发生源头，在于有“不得隐曲”（凡是不能自如的情况都称为不得隐曲）。因为心主神志，脾主思虑，人有不得隐曲的情况，其神思就会郁结，胃腑必然减少酸汁（消化食物依赖酸汁，欢喜时生成的酸汁多，忧思时生成的酸汁少），不能消化饮食，从而无法生成血液，所以在女子身上表现为月经闭止。女子的月经闭止，既然由于胃腑有病，不能消化饮食，治疗的人，自然应当调理脾胃，使其多吃饮食，以此作为生成血液的根本。因此方中使用白术来健运胃阳，使之蠕动有力（饮食的消化也依靠胃的蠕动）。山药、龙眼肉，用来滋养胃阴，使其酸汁多生成。鸡内金原本含有酸汁，且能运化各种补药的力量，使补益而不滞涩。血虚的人必然多有发热，所以用玄参、芍药来退热。又因为血虚的人，其肝肾必然虚弱，所以用山茱萸、枸杞来补益肝肾。甘草是补益脾胃的正药，与方中的山茱萸并用，更有酸甘化阴的妙处。桃仁、红花是破血的要药，方中少量使用，并非取其破血之功，而是想借它们来活血脉、通经络。至于方后附载的因证加减诸药，不过是粗略陈述大略，至于病情变化多端，尤其贵在临证医生能因时制宜。
沧州曹姓女子，十六岁，天癸（月经）尚未到来。饮食减少，身体消瘦，渐渐觉得发热。脉搏五至，细而无力。用资生通脉汤治疗，服用五剂后，发热已退，饮食增多。于是将方中玄参、芍药各减一钱，又加当归、怀牛膝各三钱。服用十剂后，身体较之前胖壮，脉象也有很大起色。又在方中加入樗鸡（俗名红娘虫）十枚，服用七八剂后，月经遂至。于是去掉樗鸡，再服用数剂，以善后巩固。
奉天马姓女子，从十四岁开始月经已通，到十五岁秋季，因为吃瓜果过多，腹泻一个多月才痊愈，从此月经闭止。请医看病，到了十六年夏末，病情逐渐加重，于是求我为其诊治。她身形异常瘦弱，气息微喘，干咳无痰，午后潮热，夜间尤其严重，饮食减少，大便泄泻。脉搏数近六至，微细无力。让她先用生怀山药细末八钱，用水调匀煮成粥，又将熟鸡蛋黄四枚，捻碎掺入粥中，再煮一两沸，空腹时服用。服后片刻，又服用西药百布圣二瓦，以帮助消化。每天如此两次，作为点心，服用四天，腹泻已止。又服用数日，其他病症也稍见减轻。于是投用资生通脉汤，去掉玄参加生地黄五钱、川贝母三钱，连续服用十余剂，发热减少了十分之八，饮食增多，喘咳也逐渐痊愈。于是将生地黄换作熟地黄，又加怀牛膝五钱，服用十剂后，自觉身体爽健，所有病症都没有了，只有月经还未见。又在方中加入土鳖虫（即土鳖虫，背部有多横纹的是真品，背部光滑的不是）五枚、樗鸡十枚，服用四剂后，月经已通。于是去掉土鳖虫、樗鸡，让她再服用数剂，以善后巩固。
马姓女子十七岁。从十六岁秋季开始，因为患右眼生内障，服药不愈，忧思过度，以致月经闭止。从腊月服药，直到次年孟秋月底仍未痊愈，求我为其诊治。她体质瘦弱，五心烦热，午后两颧色红，灼热更加严重，心中满闷，饮食少许，即停滞不下，夜晚不能入睡。脉搏五至，弦细无力。因为她饮食停滞，夜晚不能入睡，投用资生通脉汤，加生赭石（研细）四钱，熟枣仁三钱，服用四剂后，饮食增多，夜晚已能入睡，发热稍退，于是去掉枣仁，减赭石一钱，又加地黄五钱，丹皮三钱，服用约十剂，发热大减。又去掉丹皮，将龙眼肉改用八钱，再加怀牛膝五钱。连续服用十余剂，身体逐渐强壮健康。因为她的月经仍未通下，又加土鳖虫五枚、樗鸡十枚。服用五剂后，月经已通。然而流出的不多，于是去掉樗鸡、地黄，加当归五钱，让她服用数剂，以善后巩固。
To treat prolapse of the uterus (Yin Ting) in women, and also applicable to conditions of Liver Qi deficiency with stagnation and lack of free flow.
Sheng Huangqi (Raw Astragali Radix, 6 qian) Danggui (Angelicae Sinensis Radix, 3 qian) Zhi Mu (Anemarrhenae Rhizoma, 3 qian) Chaihu (Bupleuri Radix, 1.5 qian) Sheng Ming Ruxiang (Raw Frankincense, 3 qian) Sheng Ming Moyao (Raw Myrrh, 3 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 1.5 qian)
The Liver governs the sinews, its collaterals connect to the external genitalia, and it facilitates the movement of Qi for the Kidneys. Prolapse of the uterus protrudes from the vagina, resembling a knot of sinews. The cause of this disease is undoubtedly Liver Qi stagnation sinking downward. Therefore, in the formula, Huangqi is used together with Chaihu and Chuanxiong; tonifying the Liver serves to soothe the Liver, thereby raising the sinking Liver Qi. Danggui is used together with Ruxiang and Moyao; nourishing the Liver serves to regulate the Liver, thereby resolving the stagnant Liver Qi. Furthermore, fearing that the warm nature of Huangqi might be unsuitable for the Minister Fire (Xiang Huo, physiological fire) residing in the Liver, Zhi Mu’s cool and moistening properties are added to dissipate the heat.
A woman in her thirties suffered from this condition. She had previously used a formula for uterine prolapse from Chen’s *Nuke Yaozhi* (Essentials of Gynecology), but it was ineffective. Recalling that *Fu Qingzhu Nuke* (Fu Qingzhu’s Gynecology) contains a formula for postpartum uterine prolapse caused by excessive anger damaging the Liver and excessive straining during childbirth, resulting in a tissue protruding from the birth canal that resembles neither sinew nor flesh, she realized that using herbs to raise and tonify Liver Qi could cure it. Following this principle, I prepared this decoction for her. After several doses, the symptoms subsided; after ten doses, she was completely cured.
A fifteen-year-old unmarried girl suffered from sinking of the Great Qi in the chest, causing a sensation of heaviness and prolapse in both urination and defecation, particularly severe in urination. Misdiagnosed as urinary retention, she strained excessively to urinate, causing an object suddenly to prolapse from the vagina, shaped like a peach with a slight tip exposed, pulling down on the waist with pain, worse at night, so severe that she cried out incessantly. I administered Li Yu Sheng Xian Tang (Soothe Stagnation and Raise Sinking Decoction), doubling the dosage of Shengma (Cimicifugae Rhizoma). Pain ceased after two doses, and the prolapsed object disappeared completely after ten doses. This is because Li Yu Sheng Xian Tang is originally similar to Sheng Gan Shu Yu Tang (Raise Liver and Soothe Stagnation Decoction).
To treat amenorrhea and blood exhaustion in unmarried girls, accompanied by reduced appetite, feverish sensations, and cough.
Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian, stir-fried) Sheng Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma, 1 liang) Sheng Jineijin (Galli Gigerii Endothelium Corneum, 2 qian, yellow variety) Longyanrou (Longan Aril, 6 qian) Shanzhuyu (Corni Fructus, 4 qian, pits removed) Gouqizi (Lycii Fructus, 4 qian) Xuanshen (Scrophulariae Radix, 3 qian) Sheng Hangshao (Paeoniae Radix Alba, 3 qian) Taoren (Persicae Semen, 2 qian) Honghua (Carthami Flos, 1.5 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian)
If fever persists, add Sheng Dihuang (Rehmanniae Radix) 6 qian up to 1 liang. If cough is present, add Chuanbeimu (Fritillariae Cirrhosae Bulbus) 3 qian and Yingkesu (Papaveris Pericarpium) 2 qian (discontinue when cough stops). If diarrhea occurs, remove Xuanshen, add Shu Dihuang (Prepared Rehmanniae Radix) 1 liang and Yunlingpian (Poria Cocos, sliced) 2 qian, or increase the dosage of Baizhu as appropriate. If diarrhea continues despite medication, prepare a porridge with fine powder of Sheng Huai Shanyao, mixed with several crushed cooked egg yolks, taken as a snack twice daily; discontinue once diarrhea stops. For dry stools, add Danggui and Ejiao (Donkey-hide Gelatin) several qian each. For difficult urination, add Sheng Cheqianzi (Plantaginis Semen) 3 qian (decocted in a bag) or Difuzi (Kochiae Spinosae Fructus) 2 qian, or increase the dosage of Shaoyao (Paeoniae Radix), which effectively treats difficult urination due to Yin deficiency. For Liver Qi stagnation, add Sheng Maiya (Hordei Fructus Germinatus) 3 qian, Chuanxiong and Ezhu (Curcumae Rhizoma) 1 qian each. For excessive sweating, change Shanzhuyu to 6 qian and add Sheng Longgu (Fossilia Ossis Mastodi) and Sheng Muli (Concha Ostreae) 6 qian each.
The *Neijing* states: "Diseases of the Two Yangs originate in the Heart and Spleen; if there is 'bu de yinqu' (inability to act freely/psychological constraint), it manifests as amenorrhea in women." The Two Yangs refer to the Yangming Stomach Fu organ. When the Stomach is diseased and cannot digest food, tracing the origin reveals involvement of the Heart and Spleen. Further tracing reveals that the Heart-Spleen pathology stems from "bu de yinqu" (any state of inability to act freely). The Heart governs the Spirit (Shen), and the Spleen governs thought. Psychological constraint leads to stagnation of Shen and thought, reducing gastric acid secretion (digestion relies on acid; joy increases acid production, while worry/sorrow decreases it). Consequently, food cannot be digested to generate Blood, leading to amenorrhea in women. Since amenorrhea results from Stomach disease impairing digestion, treatment must regulate the Spleen and Stomach to promote appetite, establishing the foundation for Blood generation. Thus, Baizhu is used to strengthen Stomach Yang, enhancing peristalsis (digestion depends on stomach motility). Shanyao and Longyanrou nourish Stomach Yin to increase acid secretion. Jineijin naturally contains acid and helps transform the effects of tonic herbs, preventing stagnation from tonification. Blood deficiency often causes feverish sensations, so Xuanshen and Shaoyao are used to clear heat. Blood deficiency implies Liver-Kidney deficiency, so Shanzhuyu and Gouqizi are used to tonify them. Gancao is a primary herb for tonifying the Spleen and Stomach; combined with Shanzhuyu, it creates the effect of "sour-sweet transforming into Yin." Taoren and Honghua are potent blood-breaking herbs; used in small quantities here not to break blood, but to invigorate blood vessels and unblock collaterals. The modifications listed later are merely general guidelines; clinicians must adapt to specific cases dynamically.
A sixteen-year-old girl surnamed Cao from Cangzhou had not yet begun menstruation (Tian Gui). Her appetite was poor, body emaciated, and she felt increasingly feverish. Her pulse was five beats per breath, thin and forceless. Treated with Zisheng Tongmai Tang (Nourish Life and Unblock Vessels Decoction). After five doses, fever subsided, and appetite increased. Then, Xuanshen and Shaoyao were reduced by 1 qian each, and Danggui and Huainiuxi (Achyranthis Bidentatae Radix) 3 qian each were added. After ten doses, her body became fuller and stronger, and her pulse improved significantly. Ten Zhuji (Chorthippus/Mantis eggs, commonly called Hongniangchong) were then added. After seven to eight doses, menstruation began. Zhuji was then removed, and several more doses were taken to consolidate recovery.
A girl surnamed Ma from Fengma started menstruating at fourteen. In autumn at fifteen, excessive consumption of melons and fruits caused diarrhea lasting over a month. Menstruation ceased thereafter. Medical care was sought, and by late summer at sixteen, the condition worsened. She was abnormally emaciated, breathing slightly short, with dry cough and no phlegm, afternoon tidal fever (worse at night), reduced appetite, and loose stools. Her pulse was rapid, nearly six beats per breath, faint, thin, and forceless. I instructed her to first take a porridge made from 8 qian of fine Sheng Huai Shanyao powder mixed with four crushed cooked egg yolks, boiled briefly, taken on an empty stomach. Half an hour later, she took 2 wa of the Western digestive enzyme "Bupusheng" (Pancreatin) to aid digestion. Taken twice daily as a snack, diarrhea stopped after four days. Other symptoms also improved. Then, Zisheng Tongmai Tang was prescribed, removing Xuanshen and adding Sheng Dihuang 5 qian and Chuanbeimu 3 qian. After more than ten doses, fever decreased by 80%, appetite increased, and coughing/wheezing improved. Sheng Dihuang was replaced with Shu Dihuang, and Huainiuxi 5 qian was added. After ten doses, she felt healthy with all symptoms resolved, except menstruation had not returned. Tuiechong (Eupolyphaga/Steleophaga, true specimens have transverse stripes on the back) 5 pieces and Zhuji 10 pieces were added. After four doses, menstruation resumed. These were then removed, and several more doses were taken to consolidate recovery.
A seventeen-year-old girl surnamed Ma. Starting in autumn at sixteen, right-eye cataract failed to heal with medication. Excessive worry and thinking led to amenorrhea. Medication continued from the twelfth lunar month until early autumn of the following year without success. She was physically weak, with five-palm heat (heat in palms, soles, and chest), flushed malar region after noon, worsening burning sensation, chest fullness, poor appetite with food stagnation, and insomnia. Her pulse was five beats per breath, wiry, thin, and forceless. Due to food stagnation and insomnia, Zisheng Tongmai Tang was administered with Sheng Zheshi (Hematitum, finely ground) 4 qian and Shu Zaoren (Ziziphi Spinosomi Semen) 3 qian. After four doses, appetite increased, sleep normalized, and fever subsided slightly. Zaoren was removed, Zheshi reduced by 1 qian, and Dihuang 5 qian plus Danpi (Moutan Cortex) 3 qian were added. After about ten doses, fever greatly reduced. Danpi was removed, Longyanrou increased to 8 qian, and Huainiuxi 5 qian was added. After more than ten doses, her body gradually strengthened. Since menstruation still had not started, Tuiechong 5 pieces and Zhuji 10 pieces were added. After five doses, menstruation began, though flow was light. Zhuji and Dihuang were removed, and Danggui 5 qian was added for several doses to consolidate recovery.